Individual
MR. JERRY MIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S. BCBA
Contact information
Practice address
630 BJ MIXON RD, COTTONWOOD, AL 36320-5012
(334) 618-4963
Mailing address
630 BJ MIXON RD, COTTONWOOD, AL 36320-5012
(334) 618-4963
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-02-0822
AL
Other
Enumeration date
10/14/2014
Last updated
10/14/2014
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